Dyadic Developmental Psychotherapy (DDP) is a caregiver-child strategy designed to handle attachment insecurity and developmental trauma (Hughes, 2007; Golding, 2025), notably in kids from the care system who’ve skilled abuse or neglect (Selwyn et al., 2015; Burch et al., 2022). It goals to reinforce relational security by means of ideas of playfulness, acceptance, curiosity, and empathy, supporting emotional regulation and cognitive growth.
Whereas DDP has a stable theoretical basis and intensive coaching for therapists, it has not been rigorously examined by means of randomised managed trials (RCTs), limiting its classification as a confirmed intervention (Christopher et al., 2025). Moreover, qualitative suggestions from caregivers suggests elevated understanding and acceptance, indicating potential advantages for caregiver-child relationships (Wingfield & Gurney-Smith, 2019).
The present examine aimed to handle a analysis hole in understanding kids’s views on their DDP experiences (Christopher et al., 2025).
Dyadic Developmental Psychotherapy (DDP) is a caregiver-child strategy designed to handle attachment insecurity and developmental trauma.
Strategies
The examine used semi-structured, play-based interviews with six kids (one male; relaxation feminine) aged 8-12 years previous. Individuals have been both adopted or beneath a Particular Guardianship Order and had accomplished at the very least 4 classes of a DDP intervention.
Knowledge assortment employed Narrative Story Stem Methodologies (NSSM) to encourage kids to specific their experiences by means of story enactments (Woolgar, 1999), supplemented by drawing and emotion stickers to ease communication (Fane et al., 2018). 4 stems have been developed, tailored from Hodges et al.’s (2000) Story Stem Evaluation Profile (SSAP), presenting typical remedy situations or dilemmas.
Recruitment concerned accredited therapists selling the examine, with caregivers knowledgeable by way of video calls.
Classes, lasting from 35 minutes to almost three hours (imply 1.15h), aimed to be conversational, fostering a relaxed surroundings for youngsters to share their ideas and emotions.
Knowledge evaluation used Interpretative Phenomenological Evaluation (IPA), beforehand utilized in research exploring DDP expertise with adoptive dad and mom (e.g., (Wingfield & Gurney-Smith, 2019). The evaluation adopted Smith et al.’s (2021) framework and Nizza et al.’s (2021) high quality indicators for IPA research. It concerned an iterative strategy of familiarisation with the info, line-by-line coding, and figuring out patterns of convergence, divergence, commonality, and nuance each inside and throughout circumstances. To acknowledge the affect of biases (Yardley, 2000), supervision, bracketing, and reflexive workout routines have been a part of the info dealing with.
Outcomes
A complete of two fundamental themes and eight subthemes have been recognized.
Theme 1: “They’re telepathic” – Attuned emotional connection
1.1 Curiosity, empathy, acceptance, and suppleness
In 5 of the six accounts, therapists have been depicted as heat, empathetic, and versatile. Throughout moments of discomfort, reminiscent of when kids cried exterior, therapists approached the state of affairs with curiosity reasonably than merely attempting to unravel the issue.
…they’d {baby} say ‘I don’t actually really feel comfy sharing this’. After which the adults would perhaps do one thing totally different and make them{baby} comfy.” (Asher)
1.2 Lightness and play
Lightness and playfulness fostered relational circumstances that help emotional regulation, permitting kids to interact in therapeutic dialogue.
They {therapist/caregivers) similar to as a substitute of carrying on speaking about stuff {the kid} doesn’t really feel comfy speaking about, they like helped them calm down…. They performed with {the kid}, as a substitute of simply carrying on.” (Scout)
1.3 Individualised, comforting rituals and rhythms
Kids’s tales typically spotlight acquainted, non-verbal comforting rituals, like video games, drinks, and snacks, which assist construct belief and security.
1.4 Caregivers as co-therapists
Individuals indicated that caregivers performed lively roles in remedy, typically depicted as emotionally attuned and nurturing.
Theme 2: Shifting in direction of psychological security and shared intentions
Individuals initially skilled hesitation and distrust throughout their early remedy classes.
2.1 Distrust, misattunement and the position of interactive restore
For some kids, exploration can really feel susceptible, main them to defend in opposition to this sense. For instance, one participant expressed feeling scared:
I drew a scared face. Good and scared the primary time, so I drew a scared face. They {therapist} don’t know you. And so they don’t know me and also you don’t know who they’re and also you don’t know what they’ll do.” (Kirby)
2.2 Potentialities for will increase in belief
Responses indicated that every one members skilled modifications, transferring from preliminary distrust to elevated belief. Over time, conversations with caregivers and therapists grew to become simpler.
2.3 Elevated caregiver closeness
Carter noticed some modifications of their relationships with their caregivers and defined that this behaviour was initially modelled by the therapist.
They’re calmer. However {therapist} is all the time calm[…] Much less arguments I assume […] and plenty and plenty and plenty and many enjoyable! And new video games.” (Carter)
2.4 Considering loss
Considering the top of remedy can evoke emotions of loss, particularly as soon as security is established, as kids might anticipate this future transition. 4 members talked about loss of their accounts. In a single story from Carter, a baby was confused when a brand new particular person answered the remedy room door as a substitute of the same old therapist.
This examine on DDP discovered that constructing a way of belief with the therapist required time for the youngsters.
Conclusions
That is the primary tutorial examine focussing on the qualitative experiences of youngsters present process DDP interventions. Findings recommend that the qualities of attuned relationships with the therapeutic adults have been salient over any occasion or method. In keeping with preliminary and considerably restricted literature supporting DDP (Purrington et al., 2023), and in alignment with DDP’s core goals, findings infer that the attuned presence of the therapeutic adults might affect the diploma of perceived change in attachment safety.
DDP might foster alternatives for elevated attachment safety, facilitate trauma decision, and help kids and their households to be taught to thrive.
Strengths and limitations
The examine employed a play-based methodology alongside a phenomenological philosophy to discover the youngsters’s experiences, specializing in attachment safety and perceived variations. Such revolutionary strategy enabled kids to specific their experiences by means of play, assuaging the stress related to direct questioning. The usage of various knowledge assortment strategies captured wealthy insights, lowered energy imbalances, and fostered consolation for the youngsters concerned. The analysis underscores the significance of together with younger kids with trauma histories in research, supplied that the methodology is delicate and considerate. The examine highlights the necessity for understanding kids’s views, which are sometimes missed in analysis associated to providers and interventions.
Nevertheless, there are notable limitations, such because the sampling bias of together with solely these kids who superior in DDP (i.e., purposive sampling technique). This focus might have resulted in a skewed view of experiences, leaning in direction of predominantly optimistic outcomes. Figuring out the mechanisms of change in DPP observe can also be difficult because of the nature of this intervention.
Future analysis on Dyadic Developmental Psychotherapy can deal with understanding moderating components reminiscent of trauma historical past, remedy length, gender, age, and relational context.
Implications for observe
The findings from Christopher et al. (2025) point out that this new proof ought to affect medical observe for youngsters with developmental trauma histories. The examine emphasises that the responsive presence of therapeutic adults and the lively involvement of caregivers are essential for enhancing kids’s relationships and enhancing attachment safety. This highlights the significance for clinicians to prioritise relational qualities, reminiscent of attunement, responsiveness, and interactive restore, reasonably than focusing solely on technique-driven approaches.
Clinicians and repair suppliers ought to extra systematically combine DDP ideas into their therapeutic choices for trauma-affected kids, notably in contexts involving adoption, foster care, or particular guardianship. Coaching programmes ought to deal with educating the event of therapeutic alliances with each the kid and the caregiver, selling reflective functioning, and growing relational co-regulation expertise, reasonably than concentrating narrowly on symptom discount.
From a coverage perspective, funders and repair commissioners ought to contemplate directing assets towards longer-term, relationship-centered interventions like DDP and make sure that caregivers obtain express help and are included in remedy plans. Insurance policies also needs to require ongoing supervision and ability growth for clinicians to keep up high-quality relational practices, as outcomes look like influenced by therapist results.
Enhancing therapeutic practices for trauma-affected kids requires prioritising relational high quality and caregiver involvement.
Assertion of pursuits
Anamarija Veic has no conflicting pursuits to declare. She acknowledges the usage of AI in helping with the revision of the textual content to reinforce readability and correctness. This device has helped with grammar checks and rewriting lengthy sentences to extend the general high quality of the weblog.
Edited by
Dafni Katsampa.
Hyperlinks
Major paper
Christopher, J., Cresswell, C., & Davies, J. (2025). Dyadic developmental psychotherapy for youngsters with developmental trauma histories: An exploration of youngsters’s therapeutic experiences. Medical Little one Psychology and Psychiatry, 13591045251348709.
Different references
Burch, Okay., Backinsell, A., Coombes, L., & Halford, E. (2022). Analysis of the adoption help fund: First comply with up survey of oldsters and carers. Division for Schooling, London.
Fane, J., MacDougall, C., Jovanovic, J., Redmond, G., & Gibbs, L. (2018). Exploring the usage of emoji as a visible analysis technique for eliciting younger kids’s voices in childhood analysis. Early Little one De velopment and Care, 188(3), 359–374.
Golding, Okay. S. (2025). Dyadic developmental psychotherapy. In The Handbook of Advanced Trauma and Dissociation in Kids (pp. 328-344). Routledge.
Hodges, J., Hillman, S., & Steele, M. (2000). Story stem evaluation profile. Anna Freud Centre.
Hughes, D. A. (2007). Attachment-focused household remedy. WW Norton & Firm.
Hughes, D. A., & Golding, Okay. S. (2024). Therapeutic relational trauma with attachment-focused interventions: Dyadic developmental psychotherapy with kids and households. WW Norton & Firm.
Nizza, I. E., Farr, J., & Smith, J. A. (2021). Attaining excellence in interpretative phenomenological evaluation (IPA): 4 markers of top of the range. Qualitative Analysis in Psychology, 18(3), 369–386.
Purrington, J., Goodall, S., & Lynch, J. (2023). Household-based psychological interventions for domestically adoptive households: A scientific evaluation (pp. 1–18). European Little one & Adolescent Psychiatry.
Smith, J. A., Flowers, P., & Larkin, M. (2021). Interpretative phenomenological evaluation: Concept, technique and analysis. In Interpretative phenomenological evaluation: Concept, technique and analysis. Sage Publications.
Wingfield, M., & Gurney-Smith, B. (2019). Adoptive dad and mom’ experiences of dyadic developmental psychotherapy. Medical Little one Psychology and Psychiatry, 24(4), 661–679.
Woolgar, M. (1999). Projective doll play methodologies for preschool kids. Little one Psychology and Psychiatry Overview, 4(3), 126–134.
Yardley, L. (2000). Dilemmas in qualitative well being analysis. Psychology and Well being, 15(2), 215–228.
